SIHO Insurance Services
  • - Medical Management - Exec
  • Columbus, IN, USA
  • Salary
  • Full Time
  • full package

Job Title:                    Vice President of Medical Management

Reports To:    President & Chief Executive Officer

Job Location: Columbus, IN

 

 

Position Description:

This is a full time, exempt position with responsibility to direct a comprehensive Medical Management program including utilization management, case management, disease management, population health, wellness and quality improvement in accordance with the SIHO Mission, Values, and Vision including all corporate goals and objectives. This position is an executive position reporting to the CEO.

 

Position Responsibilities:       

  • Develop protocols that meet the needs of our stakeholders and that meet or exceed industry benchmarks
  • Oversee all areas and aspects of the Medical Management department
  • Act as primary strategist for continuous improvement in Medical Management regarding operational efficiency, productivity, profitability, patient safety, and quality service
  • Forecast and align the Medical Management department's goals and outcomes with SIHO's current and future company vision and values
  • Identify opportunities for development of new care management approaches and prepare proposals for implementation for senior executives and partners
  • Work with SIHO stakeholders to transform Medical Management's solutions from a clinical perspective
  • Champion reforms and ongoing guidance to the Quality Management Committee
  • Coordinate with VPs and Business Process Leaders on expected deliverables, business updates, company projects, and timing
  • Evaluate and provide feedback on programs and other key initiatives, ensuring they represent the company executives' goals and requirements
  • Represent Medical Management at high-level meetings; acting as representation to the Board of Directors, Quality Management Committee, internal executives, and business partners
  • Review and revitalize Medical Management policies and practices on an annual basis or sooner if needed
  • Selects, develops, motivates, evaluates, and leads departmental personnel which may include acting as the ultimate authority for employee hires and terminations
  • Unite all Medical Management teams and drive towards patient-centered solutions

 

Candidacy Requirements:

  • RN, NP, PA, or MD certification and/licensure
  • Proven executive leadership experience with 10+ years of progressive leadership positions
  • Demonstrable experience leading change in previous organization(s)
  • Background in operations and operational efficiency
  • Outstanding communication skills both written and spoken including presentation skills
  • Ability to certify in and maintain HIPAA certification at all times
  • Ability to align cross-departmentally with SIHO's organizational Operational Excellence Strategy in timeliness and accuracy
  • Ability to motivate staff and co-workers and introduce new processes to staff
  • Must stay current on all clinical certifications and other continuing education requirements

 

Preferred Candidacy Skills

  • Previous work experience in or with a Medical Management department
  • MHA/MBA preferred for RN certification
  • Drive to streamline processes and interest in long-standing process improvement

           

 

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